Impact of Respiratory Motion on the Quantification of Pediatric Hepatic Steatosis Using Two Different Ultrasonography...

Area of Science:

• Medical Imaging
• Hepatology
• Pediatric Gastroenterology

Background:

• Hepatic steatosis quantification in pediatric patients is crucial for diagnosis and management.
• Ultrasound attenuation imaging (ATI) and ultrasound-guided attenuation parameter (UGAP) are emerging techniques for assessing liver fat content.
• The influence of respiratory motion on these quantitative ultrasound parameters in children is not well-established.

Purpose of the Study:

• To evaluate the impact of respiratory motion on hepatic steatosis quantification using ATI and UGAP in pediatric patients.
• To compare measurements obtained during free-breathing (FB) versus breath-holding (BH) states.

Main Methods:

• Retrospective analysis of pediatric patients (≤18 years) who underwent liver ultrasonography with ATI or UGAP.
• Measurements of median, interquartile range (IQR), and IQR/median values were compared between FB and BH states.
• Statistical analyses included Wilcoxon signed rank test, intraclass correlation coefficient (ICC), and linear regression.

Main Results:

• No significant difference in ATI or UGAP values was observed between FB and BH states across 83 pediatric patients.
• Excellent agreement (ICC=0.950) for median ATI and good agreement (ICC=0.786) for median UGAP were found between FB and BH.
• The IQR/median value showed a significant association with age in the normal liver group under FB using ATI (p=0.042).

Conclusions:

• Respiratory motion does not significantly affect hepatic steatosis quantification using ATI or UGAP in pediatric patients.
• ATI and UGAP measurements demonstrate good to excellent reliability between free-breathing and breath-holding techniques.
• Younger age may introduce measurement variability in ATI for normal livers during free-breathing.